Pain  Assessment

The Pain Ladder

Pain assessment is complicated. Researchers in recent years have discovered that people feel pain differently and often react to the causes of pain more or less intensely. In other words, something that causes pain may "hurt" one individual more than another, making objective pain assessment nearly impossible.

Individuals also describe pain in different ways: mild, intense, severe, throbbing, stabbing, and pulsating are common adjectives.

The World Health Organization has offered a pain assessment scale of sorts, and it classifies pain in three ways. This pain assessment model can be described as a "pain ladder." The rungs of the pain ladder are mild, moderate, and severe.

Mild pain is said to be self-limited. This type of pain can be relieved with non-prescription pain medications like acetaminophen, aspirin, or anti-inflammatory drugs.

Moderate pain is strong enough to make it difficult for you to perform your normal daily functions and activities. However, when it's treated, it goes away and it doesn't return. You may need stronger medications to deal with moderate pain.

Severe pain makes daily living difficult because it interferes with normal activities in a big way. Very often, it doesn't go away and it may not respond to treatment. Strong prescription medications are usually necessary. In some cases, surgery is the best option.

Doctors and medical professionals generally describe pain in two general ways.

Acute pain is often intense and short-lived. It may result from an injury or some kind of physical trauma. As the injury heals, the pain goes away.

But there are other types of acute pain caused by health conditions, disorders and diseases. Angina (the type of chest pain that is caused by a heart attack) is one example. pain caused by a gallbladder attack or kidney stones would also usually qualify as acute pain.

The second type of pain is called chronic pain. This is the type that's often caused by a long term health condition like arthritis or a stomach ulcer. Chronic pain can go on for years if not treated.

How do doctors assess pain?

Pain, of course, is nature's way of telling you that something is wrong. Pain is often the first symptom that helps doctors identify a problem. Questions your doctor is likely to ask when assessing and diagnosing pain as a symptom include the following.

• Where does it hurt?
• When does it hurt (after a big meal, in the morning when you wake up, during exercise, etc.)?
• What activity or motion seems to relieve or lessen the pain?
• What causes the pain to feel worse?

The word pain may trace its origins back to the Greek word "poine." However, the literal meaning of the word "poine" is closer to "penalty or punishment" than to our modern concept of pain. Through the centuries, the Greek word may have evolved into the Latin word "poena" (meaning pain inflicted by punishment) and eventually to the Old French "peine," which closely resembles the English word's meaning.